GNAT-TV Information Form

GNAT-TV Information Form
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
May we add you to our email list?

YesNo
Are you a Comcast cable subscriber?

YesNo
How did you hear about GNAT-TV?
What services are you interested in using? (Check all that apply):

Local Events CalendarYouth ProgramsCreate mediaHire Us (Rent Facilities & Equipment, Request Event Coverage, Video Transfer Services)Non-Profit ServicesSubmit ContentOther
(Initial) I have read and understand the GNAT-TV Policy & Procedures document and will take responsibility for compliance with all the rules, procedures, and policies. False or misleading statements are grounds for forfeiture of the right to use GNAT-TV equipment and facility.
Initial Here
Should be Empty: